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The most important chapter, however, is that upon Hæmorrhoidal Affections, and it is impossible for any one who reads it attentively not to be struck with the very practical value of Mr. Ashton's remarks. He gives Montègne's classification, dividing hæmorrhoids into eight varieties, but at the same time says, “No better classification can be adopted in respect to the pathological structure of the several tumours, as well as to the treatment to be pursued, than the division into internal and external hæmorrhoids.” Internal hæmorrhoids, he says, consist of three varieties.

“ The first consists of loose folds of mucous membrane, with the submucous cellular tissue hypertrophied, the arterial capillaries abnormally developed and actively congested, the venous radicles being in a like condition. When these tumours are prolapsed, they are seen to be of a bright-red colour, spongy in texture, the surface villous like the conjunctiva in chronic ophthalmia; they readily bleed, the blood being spirted out in fine jets, as if from dilated pores, or oozing from the general surface. Its character is arterial. These tumours are usually attached by a broad base near the upper margin of the internal sphincter ; sometimes the anal integument is implicated either from the great size the hæmorrhoidal tumours have attained, or their originating near the external orifice. In the second variety the tumours are more solid, somewhat round or pyriform, with a smooth dull-colour surface. They are attached by a peduncle, and, when not prolapsed, lie in the pouch of the rectum above the internal sphincter. They are composed of mucous membrane, hypertrophied cellular tissue, and veins having their tissues much thickened. The third variety differs essentially from the two preceding, and its character would be more clearly indicated by the term vascular excrescence, it being a florid, excessively vascular, granular condition of a portion of the mucous membrane, seldom exceeding a shilling in size, and generally much smaller.”

As ointments to be applied by means of bougies to internal hæmorrhoids, Mr. Ashton speaks most favourably of combinations of conium, opium, or hyoscyamus, with spermacetic ointment (ten grains of either to the ounce); and, for the relief of excessive hæmorrhage, injections of iced water or solutions of copper, logwood, &c., are recommended; but he says he places much dependence on an injection of tannic acid, about a drachm to twenty-four ounces. At the same time, sulphuric acid or acetate of lead and opium must be given internally. The radical treatment of this form of disease is, of course, removal by means of the ligature, although, somewhat strange to say, Mr. Ashton does not seem to think that there are many cases which will not be sufficiently relieved by local applications. He says,

“In the majority of cases it will not be necessary to interfere surgically with internal piles, if the patient strictly attends to the instructions of his medical adviser with respect to diet and exercise. Even when the tumours are large, and have existed for some time, the use of soap and water externally, night and morning, the injection of cold water or lime water after each dejection, and keeping the bowels easy, will enable the subjects of them to pass their lives in tolerable comfort.”

This fact we are not prepared to deny, but must be allowed to express our doubts of its correctness. External piles must be removed, this being the only satisfactory treatment although other plans of treatment may be adopted—but it will only relieve for the time; ultimately recourse must be had to the knife. This chapter contains the record of a number of cases, all going to prove the views put forth by our author.

The other chapters of the work are all interesting and practical. The work is very neatly produced by Henry C. Lea, of Philadelphia ; he is successor to the well-known medical publishing house of Blanchard & Lea.



A Text Book on Anatomy, Physiology and Hygiene for the use of Schools

and Families. By JOHN C. DRAPER, M.D., Professor of Natural History and Physiology in the New York Free Academy, &c., &c., with one hundred and seventy illustrations, 8vo. pp. 300. New York: Harper & Brothers, publishers, Franklin Square, 1866.

Montreal: Dawson Bros. Is there a necessity for a work of this nature, and with the object professedly to teach the youth just so much of the anatomy and physiology of the human frame as would in many instances lead to the very worst results ? Dr. Draper, in his preface, says: “Although the chief object has been to " propose a text-book for academic students, the work is also designed for the use of schools and families.” Again we would seek to find the utility of laying bare (except to a strong minded woman) the many functions of the living organism. Works of this nature are not generally sought by the young for the purpose of instruction, but with a view of satisfying a morbid curiosity, and especially will you find well thumbed, and read and re-read those parts which relate to the reproductive organs. Although the space devoted to this subject in this volume is exceedingly short and concise, yet as a whole, we think it objectionable—the fashion of the age appears to be to break down that fine barrier of modesty, the very pride of the human female, and we do think that the greatest care should be exercised in the introduction of objectionable literature especially for children.




By WILLIAM S. Rowen, Act. Assist. Surgeon U.S.N. Observing your excellent article in the last number of the JOURNAL, on the injurious effects which may result from the inhalation of poisonous gases set free by combustion of “sulpho-cyanide of mercury," in the form of the new toy, the “eggs of Pharoah's serpents," I beg leave to give the particulars of a case that came under my observation a short time since in Washington, D.C. The eggs" being, as you say, one of the fashionable sensations of the day, are introduced into the drawing rooms and nurseries of many of our citizens, who are in a measure ignorant of their true character, and who may realize the fact only when serious mischief has been done.

A gentleman of my acquaintance, who has been troubled with a slight bronchial affection for several months, ignited one of the “eggs” in a close room ; and while watching the singular appearance of the mellone slowly exuding from the apex of the cone, was seized with vertigo and asphyxia, and, losing consciousness, fell to the floor, the flame from the burning "egg " igniting a portion of his clothing. He recovered in a moment, but suffered with an aggravation of his bronchitis for several days, accompanied with severe hemicrania.

I have heard of another case similar to the above, in which a child was partially suffocated by the obnoxious gases.Boston Medical and Surgical Journal.



By THEODORE C. MILLER, M.D., Athens, East Tennessee. VALERIANATE OF ZINC IN SLEEPLESSNESS.—In some form of fevers, the typhoid pneumonia, etc., where opium or morphine increased the difficulty, I succeeded admirably, by giving 2 grs. of val. zinc 4 times daily.

DYSENTERY.-In one epidemic where the disease showed more of a gastric nature, the following removed the whole disease in a few days: R Epsom salts, 3 j. Camphor water, il 3 viij. Muriatic acid, A 3 j.

A Fluid ext. ipecac, Dj.

M. S.-A tablespoonful every 2 hours.

CHRONIC DYSENTERY.—In a very severe case, after the use of a variety of treatment, I restored the patient complete in eight days, by giving the following:

R Fluid ext. cascarilla, i 3 ij. Camphor water, i 3 iij. Vinum opi, i 3B.

M. S.-Every two hours a large tablespoonful.

HYPOPHOSPHATE OF QUINIA IN DYSENTERY.-In the year 1861, August, I observed a form of dysentery, confined only to a small space of country, and which was obstinate to treat, but gave, by the administration of hypophosphate of quinia (2 grs. every 2 hours), the most satisfactory results.

LACTUCARIUM IN DYSENTERY.-In September, 1862, I observed by the combination of lactucarium with small doses of ipecac, a quick and sure remedy. It is nothing new as the same has been praised many years ago by Dr. Rothammel.-(Heidelb. Klin. Annal. v. v.)

CIMICIFUGA IN RHEUMATIC OPHTHALMIA.—In several cases, I found the fluid extract an excellent remedy. In one case it improved the patient, but did not completely cure him, till I combined it with iron.

CIMICIFUGA IN CHRONIC VOMITING.-In a case of a lady 28 years of age, who had been treated by physicians in all her reach for over a year, and who laboured for one day under a cardialgia, the next day under a severe vomiting, I gave the alc. ext. of black cohosh 2 grs. at a dose, with pulv. altheæ. in pill form. In twelve days it arrested the disease, but let her take afterwards for two months, 1 gr. pill four times dailys This was in 1861; the disease has never returned.—Journal of Materia Medica, New Lebanon, N.Y.

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Midwifery and Diseases of Women and Children.


WITH THE ENDOSCOPE; CURE. Anne Crolly, aged thirty-five, unmarried, settled in England many years, and has worked in a cotton factory ; of full habit, rather pale and Aabby, and apparently in good health, admitted June 23, 1865.

History.-Two years ago had bleeding, followed by copious hæmorrhage from the womb, which was accompanied by discharge of "clots;" this occurred suddenly, and continued eight months without intermission, but was not attended with pain. Has been repeatedly under medical treatment in England, and took mercury to salivation.

Bleeding ceased for five weeks ; it then returned, and has continued

to the present time; it is now, however attended with pain, which she describes as being of a “squeezing" kind, and accompanied by" forcing.”

Os uteri is patulous, and plugged with glairy mucus ; its lips are congested, and on the slightest irritation florid blood flows freely from them.

Examined with Dr. Cruise's endoscope ; the lining membrane of the aterus presented streaks of vascular engorgement, like the conjunctiva in a state of chronic inflammation : in several situations, also, the mucous membrane was seen to be rough and granular. It was touched, through the endoscope, with a twenty-grain solution of nitrate of silver, and the blanched surface so treated was subsequently distinctly visible through that instrument.

Treatment consisted, in addition to the above, in repeated leeching of anus, warm hip baths, injections of sulphate of alum and oak bark, mild aperients, and vaginal suppositories, composed of acetat. plumbi, gr. x, extract opii aquæ, gr. i, unguent hydrarg. Dj. M.

July 5.-Greatly improved ; no bleeding for several days, and pain in breasts, which, when hæmorrhage was troublesome, had beeen urgent, no longer exists.

Diagnosis-Dysmenorrhea from uterine congestion.
July 19.—Examined to-day ; os uteri much less patulous; it is now

; pale, and a transparent glairy mucus oozes from it ; no hæmorrhage or pain for last three weeks ; breasts still tender to pressure, but pain removed, partly by means of aconite and chloroform liniment, and gr. i

i of valerianate of zinc, ter in die ; but mainly, no doubt, by the treatment directed to the uterus. Discharged this day.

With the assistance of my colleague, Dr. Cruise, the interior of the uterus was examined by means of his endoscope, by Dr. Churchill and William Stokes, jun., at a time when vascular congestion existed in a high degree.

There can be no doubt that the practical value of the endoscope was illustrated in this case, as without the use of it—although one might infer from the symptoms the condition of the interior of the womb_it would have been impossible to have the advantage of ocular demonstration of this, and to have directed local treatment with the eye.

September 13, '65.-I received a letter from Crolly's mother to-day, from Bolton, England, thanking me "for saving her daughter's life," etc., " after she had been treated to no effect in England.”

I mention this letter, which was not in any way solicited, for the purgose of showing that up to that time the girl had continued well.-Ibid. Clinical Records of Mater Misericordo Hospital.

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