85. Ear Troubles, by Dr. S. D. Risley, Philadelphia, Pa. 86. Erectile Tumors of the Turbinated Bones, by Dr. D. H. Goodwillie, New York. 87. Primary Conjunctival Lupus, by Dr. E. S. Peck, New York. 88. Removal of Secretions from the Tympanic Cavity and Mastoid Cells,* by Dr. W. F. Holcombe, New York. 89. Causes and Relief of Tinnitus Aurium,* by Dr. W. F. Holcombe, New York. 90. A Treatment suggested for Subacute and Chronic Otitis Media,* by Dr. W. F. Holcombe, New York. 91. Observations upon Aural and Auditory Vertigo, with Cases,* by Dr. Laurence Turnbull, Philadelphia, Pa. again fell upon her knee, after which the tumor increased rapidly, and the subcutaneous veins began to enlarge. At times, when the weather was damp, she experienced sharp, shooting, or stinging pains, but, as a rule, she was free from suffering. There was some heat in the swelling; the skin was not changed in texture or color; the veins were as large as the little finger; there was some tenderness on manipulation; the consistence of the mass was firm and elastic, except at its outer side, where there was marked parchment-like crepitation. The leg could be flexed upon the thigh, but the power of extension was slight. After amputation through the lower third of the thigh, by Dr. Levis, at the Pennsylvania Hospital, the head and upper portion of the shaft of the tibia were found to have been Section VI.-On Diseases of Children (new converted into a periosteo-osseous capsule, section). Dr. S. C. Busey, of Washington, D. C., Chair man. Dr. Frank Woodbury, Philadelphia, Pa., retary. which was occupied by a firm mass, the centre of which was of a yellowish-white tint, while the peripheral portion, for an average Sec-width of an inch and a half, was of a dull red color and pervaded by cysts, some of which (ad-contained a citron-colored fluid. The tumor were an inch and a quarter in diameter and measured six inches and three-quarters in length by five inches in width, and was limited above by the articular cartilage, which was sound. 92. The Claims of Pediatric Medicine dress), by Dr. A. Jacobi, New York. 93. Bright's Disease in Children caused by Malaria, by Dr. S. C. Busey, Washington, D.C. 94. Congenital Multiple Lymphectasia, by Dr. James S. Green, Elizabeth, N.J. 95. Congenital Atrophy of the Liver, by Dr. A. Jacobi, New York. 96. A Case of Supra-Pubic Lithotomy, by Dr. A. Jacobi, New York. The chairmen of Sections I., II., and IV. also presented reports of progress in their special departments in their annual addresses, which were read at the morning sessions of the Association. PATHOLOGICAL SOCIETY OF PHILA- THURSDAY EVENING, MARCH 25, 1880. The PRESIDENT, DR. S. W. GROSS, in the chair. A Minute examination of sections taken from the red portion of the mass disclosed an exquisite example of giant-celled sarcoma, and the commencing cystic changes could be readily followed through mucoid transformation of the multinucleated elements. The central portion of the growth had undergone advanced fatty metamorphosis. Tumor of breast. Presented by DR. JOHN H. PACKARD. With report of microscopic examination of the same, by C. SEILER, M.D. Susan C., æt. 50, unmarried, Irish, a large, well-developed woman, rather old-looking for her years, living comfortably as an upper servant in a wealthy family, noticed a tumor in her right breast some time last summer (1879). She does not recollect having ever sustained any injury to the part. Becoming uneasy about it shortly before Christmas, she consulted her employer's physician, Dr. J. F. Meigs, who gave her a protective plaster and directed a tonic. Cystic giant-celled sarcoma of the head of the tibia. Presented by Dr. SAMUEL W. GROSS. SINGLE woman, æt. 20 years, presented herself at the out-patients' department of On the 12th of January she came to me by the Jefferson Medical College Hospital on the Dr. M.'s advice. The tumor had produced no 24th of January, 1880, on account of a huge visible alteration in the size or shape of the tumor of the upper epiphysis of the left tibia, breast, but could be easily felt as a condenof two years' duration. About three years pre-sation and hardening of the part. It was not viously she fell and struck her knee upon the cobble-stones; after which she experienced a sense of weakness in the joint, but did not discover a swelling until after the lapse of twelve months, when she observed a tumor, of the volume of a hen's egg, just below the lower border of the patella. For eighteen months its growth was so slow that its size had only doubled itself; but six months ago she painful, or tender on pressure, but there was some "sticking" sensation in it after it had been handled. No alteration was discoverable either in the nipple or in the skin. Her general health was good in every respect. Menstruation regular. I advised the continuance of the tonic, and the local application of a thin sheet of raw cotton, covered with oiled silk. On the 29th of January the measurement of the diseased gland was eighteen inches, the tape being carried as accurately as possible around the largest vertical circumference. The sound one measured sixteen. February 13, the tumor measured seventeen and a half inches, and February 27 only seventeen. Warty growth pendent to uvula; no symp On the 26th she had noticed a slight discharge of bloody liquid from the nipple. This still continuing, on the 27th I examined it under the microscope, and found the following elements: blood-corpuscles in large numbers: some bodies resembling the colostrum-corpuscles of milk; fine oil-drops; a few masses looking like epithelial casts of the lac-1 tiferous tubes; some cells of irregular shape, with nuclei and nucleoli; a good many free nuclei were also noticed. Many of the nuclei contained two nucleoli. Although the tumor had lessened in size, it had become decidedly harder and denser. There was no discoverable involvement of axillary or other lymphatic glands. On the 19th of March I excised the tumor, with the entire breast, ether having been administered by Dr. A. V. Meigs, and Drs. J. F. Meigs and Jesse Williamson being present and assisting. The incisions were made obliquely, so as to bevel the edges of the skin, and the wound was accurately closed with three hare-lip sutures and adhesive plaster. Carbolized cerate was used as a dressing. She had no pain afterwards, except some in the arm from the constrained position in which it was kept. On the third day, the pins being removed, the wound seemed to have united firmly throughout. On the fourth day she got up to have her bed made, and suffered only slight giddiness. I would call attention to the effect of the oblique incisions, as enabling me to close the wound very accurately, excluding the air, and giving two broad surfaces for agglutination, thus promoting rapid union, and preventing the formation of pus even in the large cavity left by the removal of such a mass of tissue. Dr. Seiler was kind enough to undertake the microscopic examination of the tumor, and to report his results : "The tumor of the breast exhibits under the microscope large distended acini, separated from each other by narrow bands of connective tissue. The epithelial cells lining | the acini are proliferating, so as to fill in many instances the entire lumen, while in others the cell-plugs are seen to have undergone cheesy degeneration. Frequently the cells are seen to have broken through the limiting membrane of the acini, and to advance in pegs into the connective tissue. Numerous depots of small-celled infiltration are observed in the connective tissue. From these appearances I would pronounce the tumor to be a carcinoma having undergone cystic caseous degeneration." sketch was made on wood by Dr. Lee, after the growth had been in dilute alcohol for several weeks. I at first supposed this specimen to be unique, but my attention was subsequently called to a very similar growth reported and figured in situ by Lennox Browne (The Throat and its Diseases, Philadelphia, 1878, Henry C. Lea). In his case very distressing symptoms were occasioned. In mine the patient was entirely ignorant of its presence, and had experienced no inconvenience from it,-not even a cough. He had a deep, hoarse voice, which very noticeably improved in tone during the two weeks he was under observation. Dermoid cyst of left cornea. Presented by Dr. A. R., æt. 18, consulted me, January 20, 1880, regarding a tumor on his left eye. The following history was given. His mother noticed, during very early infancy, a white spot, the size of a large pin's head, near the external limbus of the cornea, situated entirely on the sclerotica. It gradually increased in size as the child grew. It has never caused any pain or trouble of any kind, other than the defective vision. Present State.-O. D. healthy; V=&. In O. S. deciphered Sn. c.c. at I M. There is in O. S. a pinkish-white tumor five millimetres in height, eight millimetres in vertical diameter at the base, and one centimetre in its horizontal diameter. In shape it is a truncated cone. It is vascular at its base, and has four black hairs, the length of the cilia, growing from the top, with numerous finer, colorless ones, seen only with lens. The base horizontal line is situated half on the cornea, half on the sclerotica, and is two millimetres below the horizontal meridian of the cornea. The corneal side of the cone is steeper than the scleral side, and the base more sharply defined. The cornea is hazy, one millimetre and a half around the base, and is lifted up above the surrounding cornea, which is elsewhere transparent. The iris reacts promptly, and the anterior chamber is perfect. The deeper media are transparent, and the fundus healthy. The accompanying sketch very perfectly represents the appearance of the growth, which is undoubtedly a dermoid cyst. REVIEWS AND BOOK NOTICES. HISTORY OF MEDICINE IN NEW JERSEY, AND OF ITS MEDICAL MEN. BY STEPHEN WICKES, M.D. Mark R. Dennis & Co., Newark, N.J., 1879. The time covered by this curious work is from the earliest settlement of the province up to the year 1800. The first part of the work, giving the general history of the subject, including a discussion of the pecuniary and social position of the profession in the early time, will, we think, most strongly attract the general reader; and yet we have lingered most pleasantly over the quaint biographies in the latter pages, many of which have, to us, the peculiar charm that hangs about a mediæval church-yard and holds the wanderer fast until each moss-covered tablet has been spelled out. Quaint bits of character, whose rugged growth was nurtured by the storms of revolution; fragments of medical practice still damp with the odor of mediæval grave-vaults; anecdotes of death, of toil, of battle, with that touch of humanity in them that makes the world akin, - these, strung together with a thread of personal history which binds them to men still living and known to us, fill page after page of this entertaining volume. We picked up the book supposing that it was a whited sepulchre full of dead men's bones, but, lo, the forms are vivified by the touch of a living pen. PATHOGENETIC OUTLINES OF HOMOEOPATHIC DRUGS. By Dr. CARL HEINIGKE. Translated from the German by Dr. EMIL ZIETZE. Boericke & Tafel, 1880. Few books have ever come under our editorial notice concerning which it has been so embarrassing a task to write as the present one. If we say that it is a condensed mass of asserted facts, very many of them false, others puerile, others true, all mixed and commingled into a hopeless jumble, we will be accused of being prejudiced; but, on the other hand, if we say anything diverse from this, we will be guilty of breaking the commandment, "Thou shalt not bear false witness." On the third page of the text, at which the book first fell open, we read that the symptoms produced by aconite are "tumultuous and violent contractions of the heart; increased tension of the arterial vascular membranes; frequent, hard, and rigid pulse; more vigorous and irregular beating of the heart; spasmodic contraction of small arteries; violent febrile phenomena, with chills, heat, and perspiration; high bodily temperature," etc. To escape from our dilemma as to the true method of review, we men of the wilful ignorance of its author, or will leave the above-given extract as a speciof his scarcely more pardonable falsification. GLEANINGS FROM EXCHANGES. PATHOLOGY OF URTICARIA.-M. Vidal (Lancet, April 3, 1880; from L'Union Medicale) has published the results of the examination of a "wheal" excised during life from a patient suffering from urticaria. The superficial and deep net-work of vessels was found dilated and gorged with blood, without any alteration of their walls being discoverable. Both the blood-vessels and the lymphatic vessels were surrounded by leucocytes, which were also scattered through the whole thickness of the cutis, and massed together at certain points. A few were to be seen between the cells in the deepest layer of the epidermis. Here this structure was normal, but another piece of skin was excised from a wheal on which the epidermis had been raised in a vesicle. This vesicle contained a serous, albuminous liquid, and the débris of epithelial cells. In the middle layer the cells were vesicular, and those of the deeper layer granular. Leucocytes migrating among the cells in the deep layer of the epidermis were more numerous than in the other case. M. Vidal remarks that from this pathological alteration we can see the nature of the morbid process. In a predisposed subject some internal or local cause excites the action of the vaso-motor nerves; this excitation is soon followed by contraction of the cutaneous capillaries, and this by their paresis and congestion, with retardation of the circulation. Hence, at the centre of the altered part there is migration of leucocytes and serous effusion, the acute cedema causing the pale prominence. A similar lesion-a sort of acute oedema-may be produced artificially by injecting into the skin a few drops of water. What becomes of the leucocytes which have wandered out? Are they resorbed, or are they carried towards | the epidermic layer, as Biesiadecki suggests? It will be observed that this theory ignores any participation of the muscular fibres of the skin, which has been assumed to account for the limitation of the oedema and consequent prominence of the wheal,—a limitation which M. Vidal leaves unexplained. GANGRENE OF THE LUNG-RECOVERY.— The Lancet of April 10 contains notes of the following case, which occurred under the care of Dr. Sturgis, at the Westminster Hospital. A man of twenty-seven, who had previously enjoyed good health, caught cold, with cough, pain in the left chest, with profuse expectoration and dyspnoea, which, during five weeks, became steadily worse. At the end of that time he was anæmic, weak and thin; his breath and sputa were of the characteristic odor of pulmonary gangrene. The sputa were frothy at the surface, but had a blackish-gray layer below. On percussion there was a patch of dulness over the left base behind, about three inches square, and, on auscultating over this patch, crepitation of medium character was heard during inspiration and expiration. The other parts of the lungs gave evidence of bronchitis. Dr. Sturgis diagnosed the case as gangrene of the lung, and ordered the patient to be placed in a complete atmosphere of carbolic-acid vapor. A tent was placed around the bed-head, and vapor of carbolic acid was passed into the tent. The strength of the solution was one per cent. The patient was kept in this atmosphere for five weeks: for the first fourteen days the cough and dyspnoea were no better, but the offensive odor of the expectoration disappeared, sputa still giving evidence of pulmonary break-down. During the remaining three weeks of treatment the symptoms gradually improved, and the patient became better and stronger and increased in weight. The patient was finally discharged in good health. APOMORPHIA IN HYSTERIA. Mr. James Allen, being called to a woman whom he found in a state of hysterical coma which had lasted several days, injected one-tenth of a grain of apomorphia subcutaneously; the patient in a few moments sat up, and was able to walk home with her friends. MISCELLANY. THE editor-in-chief of the British Medical Journal receives a salary of twenty-five hundred dollars a year, while the sub-editor receives eight hundred dollars. WE have received, as one of the volumes of Wood's Standard Medical Library, a translation, by Dr. D. F. Lincoln, of the classical work by Professors Trousseau and Pidoux on "Therapeutics,"'-a book which is such a masterpiece that it still affords very pleasant and useful reading to the practitioner, in spite of the fact that modern science has swept far away from its methods. It remains, like a noble home of the old régime, still beautiful and pleasant, and rich with the reminiscences of a bygone age. CHLORAL! of blue blood the bluest, Night's long watches making shorter. Sigh no more for daylight's peeping; In its calm worn spirits steeping. OFFICIAL LIST OF CHANGES OF STATIONS AND DUTIES OF OFFICERS OF THE MEDICAL DEPARTMENT U.S. ARMY FROM MAY 30 TO JUNE 11, 1880. VOLLUM, E. P., MAJOR AND SURGEON-Having reported in person at these Headquarters, is assigned to duty at Fort Hamilton, New York Harbor. S. O. 84, Department of the East, June 1, 1880. IRWIN, B. J. D., MAJOR AND SURGEON. - To be relieved from duty at Fort Meade, upon return to that Post of Assistant-Surgeon Brechemin, and then to report in person to the Commanding Officer, Fort Snelling, Minn., for duty as Post-Surgeon. S. O. 63, Department of Dakota, May 27, 1880. HAPPERSETT, J. C. G., MAJOR AND SURGEON. — Granted leave of absence for three months, to take effect when relieved from duty in Department of the East. S. O. 118, A. G. O., May 28, 1880. BARTHOLF, J. H., CAPTAIN AND ASSISTANT-Surgeon. — Now on leave of absence; relieved from duty in Department of California, and to report in person to Commanding General, Department of the Columbia, for assignment to duty. S. O. 123, A. G. O., June 4, 1880. WEISEL, D., CAPTAIN AND ASSISTANT-Surgeon.-Granted leave of absence for four months. S. O. 122, A. G. O., June 3, 1880. BYRNE, C. B., CAPTAIN AND Assistant-SurgeON. — Assigned to duty at Fort Johnston, N.C., relieving Assistant-Surgeon V. Havard, who will comply with S. O. 74, c. s., A. G. O., in his case. S. O. 65, Department of the South, June 1, 1880. REED, WALTER, FIRST-LIEUTENANT AND ASSISTANT-SURGEON. Granted leave of absence for one month, with permission to apply for an extension of two months. S. O. 124, A. G. O., June 5, 1880. HALL, WILLIAM R., FIRST-LIEUTENANT AND ASSISTANTSURGEON. To proceed to Fort Hays, Kansas, and report to Major Noyes, Fourth Cavalry, for duty with troops ordered to New Mexico. S. O. 113, Department of the Missouri, May 26, 1880. GRAY, WILLIAM W., FIRST-LIEUTENANT AND ASSISTANTSURGEON. Relieved from duty at Fort Point, Cal., and to return by steamer, on 31st instant, to his proper sta tion, Vancouver Barracks, Wyo. T. S. O. 75, Division of the Pacific and Department of California, May 26, 1880. PHILADELPHIA, JULY 3, 1880. A CONTRIBUTION TO THE STUDY OF THE PHYSIOLOGICAL ACTION OF QUINIA AND CINCHONIDIA. BY DAVID CERNA, M.D., PH.D. Read before the Society of the Alumni of the Auxiliary Department of Medicine, University of Pennsylvania. OF F the cinchona alkaloids, quinia appears to be the one of which the most thorough physiological and therapeutical investigation has been made. Cinchonidia has lately been used somewhat extensively, therapeutically, with much apparent success; but no physiological study of it, so far as I know, has been undertaken. Based, therefore, upon no previous study, my few observations with this substance may be considered as entirely original. Those upon quinia either do or do not corroborate the conclusions arrived at by other investigators. I will first treat of the effects of quinia on the nervous and circulatory systems. PHYSIOLOGICAL ACTION OF QUINIA. On the Nervous System.-I may say that for the literature of the subject I am greatly indebted to Professor H. C. Wood's unrivalled work on "Therapeutics." Reflex action under the influence of quinia has been studied by different observers, but it has not, so far, been definitely settled. Some writers, as Schlockow and Eulenberg (Reichert's Archiv für Anatomie, 1865), have seen a diminution from the first, the loss of the spinal function taking place before voluntary motion was at all affected. A stage of increased activity was, however, observed by Henbach (Centralblatt für Med. Wissenschaften, p. 674, 1874) preceding the subsequent lowering and final abolition. These are certainly contrary statements, but I think they can be reconciled and proven to be both correct. In his experiments Eulenberg has used very large doses of quinia, which was probably also the case in Schlockow's studies, while Henbach in his observations employed minute quantities of the drug. Of course we can readily understand now that no stage of increased activity was seen by Eulenberg, for certainly quinia in enormous VOL. X.-20 doses paralyzes from the beginning all reflex activity. In my experiments I have never seen a stage of increased reflex action when large doses of the alkaloid were used, while, on the other hand, I have almost invariably observed this stage when comparatively small quantities of quinia were given. The following experiments show this: Exp. I.-Frog. Reflex action in 5 seconds. 12.19 P.M., injected grm. quinia. 12.25, reflex action in 10 seconds; 12.41, reflex action in 21 seconds; 12.45, reflex action very feeble, as shown by the acid solution used for experimentation (strength, 5 gtt. of H2SO, to the ounce of H,O). Exp. II.-Frog of about the same size as last. Reflex action in 2 seconds. At 12.36 P.M. grm. was given. 12.41, reflex action in I second; 12.45, reflex action in I second; 12.53, reflex action in 3 seconds; 12.56, reflex action in 4 seconds. It is seen, thus, that in the first experiment, where I used a comparatively large dose of quinia, the reflex activity was lessened from the beginning, while a stage of increased action was noticed in the second experiment, where a small dose was given. I shall first discuss this stage. For the production of increased reflex activity. there are four factors,-spinal sensory and motor nerve-centres and sensory and motor nerves. Now, how does quinia, in minute quantities, act to increase reflex action? That neither the sensory nor the motor centres of the cord have anything to do with the result in question is proven by the following experiment, which is an example of others of the kind performed: Exp. III-Large frog. Tied abdominal aorta. Reflex action (after recovery from the shock) in 4 seconds. grm. quinia was then injected, at 1.10 P.M. 1.15, reflex action in 5 seconds; 1.20, reflex action in 5 seconds; 1.30, reflex action greatly impaired. In this experiment, by tying the aorta, the sensory and motor nerves were protected from the influence of the drug; under these circumstances there was no increase of reflex activity at the beginning, showing, I think, that it is produced in the normal animal by stimulation of either the sensory or motor nerves. The motor nerves are not affected one way or the other by minute doses of quinia, as shown by my experiments with the Dubois-Reymond galvanic coil. Therefore I must come to the conclusion that the Peruvian alka |