The quarantine of passengers has been decried as barbarous and inhuman; and certainly none would be more anxious to grant them better accommodations than the officer in charge. When we, however, consider that the disease is not in the vessel, but among her passengers, and will necessarily accompany them wherever they ago, that the accommodations on board the vessel, if scanty, are at least adequate to their wants and such as they are accustomed to, the neglect of the authorities to provide proper accommodations, though not less flagrant, was at least shorn of its alleged inhumanity and barbarity; in fact, that debarcation does not eradicate the disease, any medical man will admit, and as an instance in proof, I may mention the case of the "North America," in 1854. Cholera existed on board of that vessel two weeks before her arrival in port. Ten of her passengers had died during that time, and 7 cases were sent to the hospital on her arrival. The day following, all her passengers were landed. In three days, 128 cases and 32 deaths occurred among 250 passengers, while the crew remained perfectly healthy, and no new cases could be traced to the vessel. The passengers of the "Atalanta" received pratique ten days after the occurrence of the last case, and the vessel, a few days afterwards, was thoroughly cleansed and repeatedly fumigated.

As facts are the only true basis of inference, I have limited my observations to simple recital of facts. Facts alone can guide us in a practical rational quarantine, and however much even medical men may differ as to the mode of its administration, all, I think, must agree upon the necessity of quarantine, both of sick and exposed.

DIABETES IN A MONKEY.

Dr. Bérenger-Féraud recently related to the Société de Biologie a cased of diabetes in a monkey. Being well aware of the liability to tubercular disease among animals brought from warm regions, he attempted to find the result of modifying their aliment; and for this purpose gave to two monkeys food more rich in nitrogenous matters than that which they ordinarily use. One of the animals refused to eat animal food, and soon died of acute tubercular disease. The other readily ate it; and at first appeared to thrive. But, during apparently flourishing health, and a full supply of rich food, the animal became rapidly lean; and was troubled with unappeasable thirst. The urine increased in quantity, and left by evaporation a residue recognizable by chemical tests as glucose. Amaurosis and convulsions supervened; and the animal died three months after its arrival in France.-Gaz. Méd. de Paris and Brit. Med. Jour.

Surgery.

CASE OF LIGATURE OF THE EXTERNAL ILIAC ARTERY.

(Under the care of Mr. ADAMS, London Hospital.)

ON November 17, Mr. Adams tied the external iliac for the cure of an aneurism of the common femoral artery. The case was that of a woman, aged 53, and was peculiar from its being supposed to have originated from a kick in the groin received three years ago. A swelling resulted from the violence inflicted, and remained stationary until five months ago, when it began to enlarge until it increased to the size of two fists, and extended into the pelvis at least three inches. The limb was much swollen and very tense in some parts, owing to the pressure upon the vein. The minute capillaries of the skin were much distended.

An incision of at least five inches was made in the usual situation, and the layers of abdominal muscles and the fascia transversalis were carefully divided, and the artery was readily secured.

The case has progressed satisfactorily to the present time (Dec. 23,) the tumour has much diminished, and the leg has returned to its natural shape and size.

The ligature came away on the twenty-ninth day.

STRICTURE OF THE URETHRA OF TWELVE YEARS' DURATION, INFILTRATES OF URINE, ABSCESS IN PERINÆO, SUBSEQUENT FISTU

LOUS OPENING, IMMEDIATE DILATATION. CURE.

By BARNARD HOLT, Senior Surgeon to the Westminster Hospital.

R. B., a labourer, was admitted August 10th, 1865. He had suffered from stricture for twelve years, and for some time previous to admission had only been enabled to pass his urine in drops. The late Mr. Brown of Stratham, under whose care he was, failing to get any instrument into the bladder, sent him to the hospital; upon admission it was found he had infiltration of urine to a great extent, there had been a large abscess in the perinæum through which the urine escaped freely, his general health was much damaged, and he was much emaciated. I endeavoured to pass a small catheter, but upon several occasions I failed to get beyond the first stricture, which was in the spongy part of the canal, I, however, eventually succeeded in passing the smallest sized gum elastic catheter through two other strictures into the bladder. This was fastened. Upon the following day I succeeded in introducing a larger size, and eventually I passed the dilator and split the strictures, which were very dense and offered considerable resistance to the tube. This being the largest size

the urethra would take, the urine was removed upon the first four occasions by the introduction of the catheter, and the after treatment was properly carried out. The fistulous openings speedily healed; the man could pass his water in a full stream, and his health greatly improved. He now only requires the passage of the No. 10 bougie once a month. This was another example out of many that have been already recorded of the rapid manner in which an obstinate and complicated stricture might be at once relieved, and the patient be speedily restored to health; it was also a good example of the rapidity with which urinary fistula will heal with retaining any instrument in the urethra, so soon as the urethra is restored to its natural dimensions.-Dublin Medical Press and Circular.

ACCUPRESSURE.

The Medico-Chirurgical Society of Edinburgh held its first meeting on Wednesday, the 18th November. A paper was read by Dr. W. B. McKinlay, on the much debated question of "Accupressure." Dr. McKinlay occupies the positions of Surgeon to the Infirmary and Surgeon of Police in Paisley, and has been able to test, in a large and valuable experimental field, the advantages of accupressure. The opinion he has formed of its applicability to Surgery, major and minor, may be best understood by repeating his statements that he now, as a rule to which there are extremely few exceptions, employs accupressure in his Hospital practice, and that his pocket-case for private and police practice contains no other hæmostatic except the means required for accupressure. He. finds, generally, that secondary hæmorrhage is now never met with by him, that all his operations are brought to a termination more speedily than before employing this agent, and that it has not been a cause of pyæmia, as this has never been seen in Paisley within his experience. Dr. Patrick Watson, one of the Surgeons in the Edinburgh Royal Infirmary, spoke warmly in favour of accupressure. At one time one of its most determined opponents, he had been induced to give the method a trial, and was so firmly convinced of its superiority that ligatures are now very rarely used by him. He spoke of its great advantages in excisions, even of the knee, and instanced a case of castration where complete recovery occurred on the third day. Professor Simpson, in a speech of considerable length, referred to various objections, which he attempted to combat, especially complaining that some Surgeons had ignorantly modified his method in a manner which completely annulled the advantages claimed for it, by forgetting the short time the needles should be retained. He announced his firm belief that accupressure, or, possibly, some more

perfect method of avoiding interference with healing by the first intention, was certain rapidly to extend and instanced Aberdeen, where all the Hospital Surgeons, except one, employ it alone. At this mecting it appeared a significant fact that only one gentleman, Dr. Gillespie, attempted to hint that the method by ligature had been unfairly decried, and accupressure extravagantly praised. A large proportion of the Medical Profession in Edinburgh, we are morally persuaded, are not inclined to occupy the position of exclusive advocates of either method, but rather that milieu which is so often juste. It appears as yet the only logically tenable position when, on the one hand, we refer to the favourable experience of Paisley and Aberdeen; and, on the other, to the more than doubtful experience of Carlisle and Liverpool.-Correspondence Med. Times and Gazette.

Midwifery and Diseases of Women and Children.

THE MANAGEMENT OF THE THIRD STAGE OF LABOUR.
By DR. H. EASTLAKE.

Having briefly described the opinions which existed amongst the accoucheurs of times gone by, the author proceeds to give an account of the modern views and principles which govern the placental stage of labour, Dr. Eastlake lays great stress upon the hand being placed firmly on the fundus uteri at the moment the child is being expelled, the uterus being thus followed down, and the contraction maintained by gentle pressure. He states that external manipulation, judiciously applied, was, in the majority of instances, quite sufficient per se to effect the expulsion of the afterbirth, without any traction whatever on the funis. He believes that the great secret is to exert the pressure during a contraction; in short, to act in unison with nature as we did in the application of forceps, where we applied our chief force at the moment of a pain. Dr. Eastlake says he had no doubt that many would imagine that, after all, this was no modern idea; but he demonstrates that this teaching was not definitely described and insisted on in our manuals of obstetrics. Dr. Credé, the Professor of Midwifery at Leipsic, appeared to be the only one who had advocated this doctrine and brought it prominently before the profession. The author next considers the subject of retained placenta, and alludes to the various causes which arrest nature's process of extruding the afterbirth. The three steps in the natural expulsionnamely, (1) the detachment from the wall of the uterus, (2) its extrusion from the uterine cavity, and (3) its expulsion from the vagina-are duly

recognized and dwelt upon. Regarding the subject of morbid adhesion of the placenta, Dr. Eastlake throws out a suggestion as to the possibility of being able to diagnose this condition by means of auscultation. He reasons by analogy in stating that for a long time he had been fully persuaded that by means of auscultation we often possess not only a negative but a positive sign of foetal death. He describes a peculiar modification of the uterine souffle, which to his ear was very characteristic when fœtal life had been extinct for any time. The alteration in tone suggested the idea of a muffled sawing noise, very different to the gentle blowing murmur heard in normal cases, where a living child existed in utero. How soon the modification took place the author is unable to state, from want of sufficient field for observation. He considers that no ergot of rye should be given in cases of retained placenta, unless we were quite sure that no abnormal adhesion or irregular contractions existed. In cases of spasm of the os uteri, where the placenta became encysted, the administration of chloroform is recommended. Another point of interest alluded to by Dr. Eastlake, bearing upon the subject of his paper, is the occasional existence of a supplemental afterbirth, which was spoken of by Dr. Barnes, Dr. McClintock, and other authors, under the name of placenta succenturiata or placenta spuria. Dr. Eastlake has seen a specimen of such an afterbirth in the museum of the Lying-in Hospital in Dublin, obtained from an ovum of five months. When such a mass remained in the uterus after the true placenta had been expelled, it often gave rise to secondary hemorrhage, and an impression arose that due caution had not been exercised in the extraction of the afterbirth. He agrees with Dr. M'Clintock that, remembering the possibility of such an occurrence, we should be slow to utter any opinion which would damage the character of a professional brother. In conclusion, the author alludes to the several conditions which generally authorize us to have recourse to a speedy removal of the placenta, such as post-partum hemorrhage, convulsions, rupture of the uterus, and possibly, under certain circumstances, where the uterus was inverted, with the afterbirth still adherent - (Proceedings of Obstetrical Society of London.)-Medical Times and Gazette.

Munificent Gift.-The sum of £20,000 was, on the 23rd January last, presented to the Middlesex Hospital, through the chairman of the weekly board from an anonymous donor.

Madame de Castilnau, wife of the French Consul at Singapore, asserts that she has discovered the animal which causes cholera. It is a

"winged leech."

Mr. Henry Thompson has received the appointment of Surgeon-Extraordinary to His Majesty Leopold II., King of the Belgians.