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treat these fractures in the above manner, and to pay particular attention to the use of passive motion as early as possible.

In cases where there is shortening, which cannot be controlled by the ordinary appliances, extension by a weight attached to the lower fragment, and counterextension by means of elastic bands attached to the upper, passed across the body and fastened to the bed, is often employed.

In fractures high up, where there is displacement forwards, the side of the thorax may be used as a splint by placing a small pad in the axilla, coaptation splints around the arm, and over these a firm, well-starched Velpeau bandage. In this manner all leverage upon the lower fragment by the movements of the forearm is avoided. Instead of the Velpeau, a many-tailed bandage, the ends of which pass round to the opposite side of the body and are there tied, may be used.

Compound fractures of the humerus.-Where the external wound is small, it is sealed with lint soaked in compound tincture of benzoin, or carbolic oil; where it is more serious, it is thoroughly washed out with a solution of carbolic acid and done up in a "Lister dressing," carbolized cotton batting dressing, "Phenyl dressing," or constant irrigation with a carbolic solution is used. The above treatment is the one used in all compound fractures, whether of the upper or lower extremity.

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In cases where the external wound is but slight, splints similar to those used in simple fractures are applied at once. Where the wound is more extensive, the arm, done up in one of the dressings mentioned above, is in many cases placed in a tin tray, or one made of gauze and plaster, and packed around with oakum, or carbolic gauze; and the wound is kept as far as possible in an antiseptic condition. As soon as the condition of the wound is such as to allow of more active treatment, splints of various shapes, which will as far as possible admit of the wound being dressed without necessitating their removal, are applied.

COLLEGE OF PHYSICIANS AND SURGEONS,
NEW YORK.

(Clinic for Diseases of the Throat.)

CASES OF RARE CONGENITAL DEFORMITY OF THE POSTERIOR NARES AND THROAT. (Under the care of PROF. GEO. M. LEFFERTS.) CASE I. Double Septum.-The following curious abnormality was only discovered by accident during the rhinoscopic examination of a young man æt. 25, who had applied for treatment for a chronic catarrhal pharyngo-laryngitis. The posterior edge of the septum narium, from its point of mergence into the parts making up the vault of the pharynx to one half way in its course from the floor of the nares, was divided vertically into two distinct halves, enclosing between them a space large enough to contain perhaps the end of a lead pencil. This space was more or less triangular in shape, its base lying above, and was lined apparently with normal mucous membrane. Its depth was not ascertained, but an anterior examination of the nasal passages disclosed nothing abnormal as to the configuration of the septum. There was no history of injury to the nose or skull. No symptoms were referable to the condition, and its presence was of course unknown to the patient.

CASE II. Congenital Lateral Deficiencies of Velum.— A girl, æt. 19, in attendance upon the clinic for the treatment of an ordinary catarrhal affection of the throat, has, through the velum palati, to either side and just above the point where the anterior pillar of the See Boston Med. and Surg. Journal, July 14, 1881. Antiseptic Surgery, Dr. H. H. A. Beach.

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fauces loses itself in the broad expanse of the soft palate, a symmetrical, ovoid perforation the size of a small pea.. The edges of these openings are smooth and rounded, are free from all cicatricial tissue, as are the parts in the immediate neighborhood, and are soft and lax.. The patient has never had ulcerated sore throat nor indeed any severe affection of the parts, and remembers that the openings here described have always existed without change, a statement that is corroborated by her mother. The condition gives rise to no inconvenience, and demands no surgical interference.

Remarks.-The rarity of such instances as are here reported renders them of interest. They are, however, to be regarded as curiosities, and as of little practical import, except in so far as the recognition of their possible occurrence will guard against diagnostic errors. I know of but one case recorded in literature similar to the first described (Schrotter, Laryngologische Mittheilungen, Wien, 1875), and of none similar to the second. Langer, in a series of investigations of embryological sphenoid bones, suggested by the case just alluded to, found that a canal exists between the two halves of the sphenoid during the first months of fœtal life, and rightly, I believe, classes such cases as the one that I have described as being due to an arrested development.

The same explanation probably holds good for the second case, but is not so readily demonstrable; indeed, the very seat of the lesion, away from the median line, militates to a certain extent against the hypothesis. No other, however, suggests itself for this particular and peculiar deformity occurring in this locality.

HOSPITAL OF

THE UNIVERSITY OF PENNSYLVANIA.
Service of D. HAYES AGNEW, M.D.

A POSSIBLE COMPLICATION IN LITHOTOMY. (Reported by J. WILLIAM WHITE, M.D.) DURING a recent clinical lecture, Dr. Agnew, who was about to perform lithotomy, called attention to a temporary condition of the patient which necessitated delay. Etherization was complete, but the respiratory movements were hurried and excessive; the sphincters of the anus were entirely relaxed, and the anal aperture was patulous, an inch and a half or two inches in diameter, and moving in sympathy with the expansion and contraction of the thorax. In this manner it seemed to act as a valve, admitting air to the rectum, but not favoring its expulsion, so that for several minutes the lower bowel was in a state of distention. Of course, there would have been great danger of wounding it if the operation had been proceeded with under these circumstances. In a short time, however, as deeper anæsthesia was produced, the anus resumed its normal appearance, and the rectal dilatation disappeared. So far as we know, this possible complication of lithotomy has not been alluded to.

JEFFERSON MEDICAL COLLEGE HOSPITAL.

CASES OF REMOVAL OF THE BREAST FOR CARCINOMA. (Under the care of DR. SAMUEL W. GROSS.)

IN carcinoma, Dr. S. W. Gross makes it an invariable rule to remove not only the entire breast, but its investing skin, connective tissue, and fat, the fascia of the pectoral muscle, and the axillary glands. If the muscles are involved, the nodules are unsparingly excised, and the apparently sound parts touched with the actuał cautery or a strong solution of chloride of zinc. Even when the glands in the axilla are not palpable prior to operation, that cavity is always opened and thoroughly explored with the finger, since in not a few instances incipient glandular involvement is detected in this way.

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In dealing with the glands, if they have served as sources of infection of the surrounding tissues, through which they are matted together and form a confused mass, the contents of the axilla are removed by a formal dissection, care being taken to pass a catgut ligature around the vessels before they are divided. When, on the other hand, the disease is limited to the glands, and the carcinomatous structure is contained within their capsules, they are simply enucleated by the finger, or a pair of scissors curved on the flat. When there is much oozing from the pectoral muscle, the hæmorrhage is readily restrained by the application of napkins wrung out of hot water. The entire wound is then washed with a two per cent. solution of carbolic acid; a drainage tube is inserted into the axilla; the wound is closed as accurately as possible by sutures inserted some distance from its edges; and lint imbued with carbolized cosmoline, confined by a broad flannel roller, finishes the dressing. Conducted in this way, Dr. Gross believes that a certain proportion of cures follow the operation; an assumption which is verified by Case III. The scar left by such thorough removal of the tissues is remarkably small. In Cases II. and III., it was not over an inch in width, and it was soft and pliable. In Case I., the large wound was reduced, by the insertion of sutures and the application of adhesive strips, to an area one-third less than that of the palm of the hand.

CASE I. Scirrhus of the Breast, Skin, and Axillary Glands-Thorough Removal of the Affected Structures. -A robust, healthy-looking woman, forty-two years of age, the mother of nine children, first noticed, twentyfour months ago, a small lump above the right nipple. The latter began to retract at the expiration of one year; and at the same time nodules appeared in the skin, the largest of which, an inch in diameter, was situated near the mammilla, and the others, to the number of seven, occupied the upper and sternal borders of the heart. At the expiration of sixteen months, she noticed lumps in the axilla, which now formed a dense elongated mass in that cavity. There were no antecedents, nor was there pain in the upper end of the humerus on pressure. The entire organ, with its investments, and the pectoral fascia, was removed by a circular incision; the axilla was opened by a cut, which extended from the upper and outer side of the pectoral incision, and the diseased mass of glands, fat, and connective tissue were dissected out, seven vessels requiring ligation. The temperature rose to 100°, and the pulse to 120, on the following morning; after which they gradually fell, and became normal on the morning of the fourth day. At the expiration of two weeks, when the granulations had reached the level of the surrounding skin, twelve epidermic grafts were inserted, and, when we saw the patient two days later, ten had taken.

-Thorough Removal-Permanent Recovery. On the 4th of September, 1878, Dr. Gross amputated the entire breast, and cleaned out the axilla of a single woman, forty-eight years of age. The tumor was of twelve months' duration, and as large as a small lemon; the nipple was retracted, and the skin was adherent. At the end of six weeks the entire wound had closed, and the woman has since performed her duties as a laundry maid with perfect comfort. The cicatrice is soft and mobile, of a natural tint, and hardly an inch in width, and there is not the least sign of recurrence in the axilla. Thirty-eight months and a half have now elapsed since the operation, and Dr. Gross has every reason for assuming that the result is final.

MEDICAL PROGRESS.

TREATMENT OF EPITHELIOMA OF THE NECK OF THE UTERUS. Dr. CHÉRON, referring to the Italian experiences with this practice, employs the nitrate of lead in ulcerating epithelioma of the uterine neck. After cleansing the surface with charpie moistened with glycerin, or washing out the canal with perchloride of iron solution if there is much oozing of blood, he applies to the ulcerated surface with an insufflator the following powder: Plumbi nitrat. purif. 31. Lycopodii Zij. The powder is kept in position by a suitable tampon. Under the action of this preparation the suppuration diminishes sensibly and the odor disappears. The hæmorrhages are also suppressed. After twelve or fifteen of these applications, the engorgement of the cul-de-sac diminishes, and the general health is greatly improved.-Journal de Thérapeutique, October 10, 1881.

A NEW THEORY OF URÆMIA. MM. FELTZ and RITTER have recently announced that the real cause of uræmia is a change in the proportional quantity of potassa in the blood. The amount of the potassic salts in the blood, as in the urine, varies with the quantity and quality of the food. A special alimentation, in which the sodic salts preponderate, long continued, has the same effect on the quantity of the salts of potassium, as a poor and insufficient diet. The quantity of the salts of potassium contained in the blood influences in a certain degree the amount of urea necessary to produce grave or fatal results. Suppression of the renal function by the simultaneous ligation of the ureters determines in the blood and in the serum a sensible increase in the potassic salts except the supplementary gastro-intestinal excretion. In this respect the alkaline salts obey the same law as urea and extractive matters, which increase in the blood under the same conditions. The most serious results of experimental uræmia are not connected with the retention and accumulation in the blood of the urea or extractive matters of the urine, but, on the contrary, are produced by the injection of fresh, normal urine, or of equivalent solutions of the salts of potassium in distilled water. We think it must be admitted that the real agents of the toxæmia are the salts of potassium which accumulate in the blood.-Bull. Gen. de Thérap., September 15, 1881.

CASE II. Recurrent Scirrhus in the Axilla-Thorough Removal.-A married, healthy woman, fifty years of age, was subjected to amputation of the entire breast (which was ulcerated, but mobile on the chest, and in the investing skin of which, towards its sternal border, there was a small carcinomatous nodule), and excision of infected axillary glands, on the 23d of October, 1880. On the 16th of November, 1881, the cicatrice was soft, pliable, and not over an inch in width; but a gland on the side of the chest, at the termination of the cicatrice, and a mass of glands in the axilla, were readily detected, of the existence of which she had no knowledge. Dr. Gross made a clean dissection of the axilla, removing a mass of glands and infiltrated tissues, along with an enlarged gland beneath the lower border of the pec-solutely opposed to all fermentation. Recognizing that toralis major muscle, a few of the fibres of which were also excised. Six vessels, including the subscapular artery and vein, were tied.

CASE III. Scirrhus of the Breast and Axillary Glands

THE TREATMENT OF TYPHOID FEVER BY ANTIZYMOTICS.-Dr. PECHOLIER, Agrégé of the Montpelier Faculty of Medicine, writes to the Bulletin Gen. de Thérapeutique, for September 15, 1881, on this topic. It is well known, he says, that creosote or phenic acid is ab

typhoid fever is produced by a special ferment, he concluded to attempt the arrest of the pathological fermentation by the administration of antizymotic remedies, so long ago as 1868, and he therefore claims priority in

this mode of practice. MM. Desplats, Hallopeau, and Raymond, have ascertained by the graphic method the antipyretic action of the antizymotics. The special fermentation, which is the initial phenomenon of typhoid, is accompanied by the production of heat, as is the case in all kinds of fermentation. It is by suspending or moderating this fermentation, that creosote or phenic acid lowers the thermic curve. Large doses, he holds, are not necessary, and there is the danger in their use of exciting gastro-enteric irritation. When he finds prolonged administration necessary, he gives the remedy by rectal injection-10 drops in 150 grammes of water (about 5 ounces). The injections have, he thinks, a useful detergent and disinfecting action. This practice is not incompatible with the methods of hydrotherapy, but reserving cold baths for special cases, he generally employs tepid baths of 822° to 91% F., but he does not the less continue his practice of combating typhoid fermentation by the measure above mentioned. Proceeding in this way he has obtained remarkable results, and if not able to declare with M. Glénard, that in his hands no deaths occur from typhoid, he is happy in being able to affirm that deaths occur but rarely.

REMOVAL OF UTERINE POLYPI.-At a recent session of the Paris Academy of Medicine, the procedure adopted by several surgeons for the removal of uterine polypi was brought out in the course of the discussion. Léon Labbé uses the galvano-cautery; Verneuil, the wire écraseur; Gosselin, scissors; and Trélat contends that each plan has its excellences, and may be em-ployed according to circumstances.

DIABETES INSIPIDUS TREATED BY ELECTRICITY.— Mr. C. P. B. CLUBBE reports the case of a woman, aged thirty-five, who was suffering from diuresis, and in whom iron, nux vomica, valerian, and bromide of potassium had been used without any marked effect. Faradism over the region of the kidneys was then employed every day for about twenty minutes for twenty weeks. There was very decided improvement up to the seventh week, when the daily average of fluid passed varied very slightly; improvement, however, being constant. Treatment was then stopped, and six. months afterwards she was no worse, though still passing from six to seven pints of urine daily.-Lancet, October 29, 1881.

microbe-bacillus malaria. The history of this parasiteis not complete from the point of view of its pathogenetic and morphologic properties, but enough is known of its biological status to throw great light, it is probable, on certain important questions of public hygiene.

PROF.TOMMASi-Crudeli on tHE MALARIA OF ROME. SUCCESSFUL EXTIRPATION OF THE SPLEEN.-Dr. Fer--In 1879 Klebs and Tommasi described the malaria nando Franzolini, attached to the Civil Hospital of Udine, and well known in Italy as a bold and careful operator in cases of abdominal surgery, has the honor of being the first in his own country to remove with success a diseased spleen. The operation has been performed now some 25 times in Europe, of which 3 or 4 cases were in Italy, with the result of saving in all 6 patients. Dr. Franzolini operated in the hospital named, on September 20, ult., upon a young woman of 22 years of age, affected with "simple, true, idiopathic hypertrophy" of the organ, and a month later she was reported as having recovered. The tumor extracted was 91⁄2 inches long by 6 inches wide, and weighed over 3 pounds. The abdominal incision extended from 434 inches above the umbilicus to 4 inches below it, and the operation lasted 1 hour and 25 minutes. The method of Lister was fully carried out. All of the ligatures were dropped into the abdominal cavity, and the wound was closed without drainage. No blood escaped into the abdo

men.

Dr. Franzolini was also the first in Italy to perform Battey's operation with success. This was on August 14, 1876, and to remove, with like result, the uterus and ovaries in a non-pregnant woman. His only Porro case was lost, as the woman was in extremis when he operated upon her.

LEUCOCYTHEMIA.-Dr. J. E. Graham, Lecturer on Clinical Medicine in Toronto School of Medicine, gives the following as his conclusions from the study of a case of leucocythæmia:

1. That the essential features of leucocythæmia are the lymphoid growths, and the leucocytes found in the blood derived from them. 2. That the existence of similar growths is the essential feature of Hodgkin's disease, but in it the cells, for some reason which I cannot explain, do not find the way into the circulation. 3. That in both diseases the presence of these growths or deposits interferes with the manufacture of the red corpuscles producing anæmia. 4. That these growths bear a strong resemblance to those of a malignant character, especially sarcomata. 5. That progressive pernicious anæmia may arise as a consequence of leucocythæmia or Hodgkin's disease in the same way as it sometimes results from pregnancy, or any other condition which interferes with the proper elaboration of the blood.-Canadian Journal of Medical Science, November, 1881.

The bacillus malariæ is an organism requiring air.. The germs or sporules are often encountered in soils of very different composition, and frequently poor inorganic substances. Malarial soils are often found in localities which are not, and have never been marshy.. In Italy malaria-breeding soils are found in some lowlands and on some mountains. On the other hand, all marshes are not malaria-producing. In all malarial localities the multiplication of the bacillus malariæ takes place under three conditions: a temperature of about 68° F.; moderate but permanent humidity; and the direct action of the oxygen of the air on all parts of the mass. If one of these three conditions is absent, the multiplication of the bacillus and the development of the sporules are arrested. Hence it is that the most pestilential marshes do not engender malaria-although the temperature may be very high-when they are wholly covered with water, and no air can penetrate to the malaria-breeding soil. In the mud of malaria marshes the malaric ferment is always associated with a septic ferment. This association may be considered fortuitous. It is easy, in fact, to terminate all the phenomena of putrefaction in the palustral mud, and also to remove from them the power to produce septic infection, by means of a proceeding which augments the production of the malarial ferment to that degree that it becomes capable of producing pernicious fevers.-Journal de Thérapeutique, October 25, 1881.

PURPURA HÆMORRHAGICA IN ITS RELATIONS TO MENSTRUATION AND PREGNANCY.-Dr. ALBERT PUECH gives the following conclusions as expressing the results of his study of purpura:

1. Purpura hæmorrhagica occurs more frequently in the female than in the male.

2. It exerts a marked influence on the uterus whether in the empty or gravid state.

3. In the empty state, its influence can be manifested. in three ways: a. It can suppress the menstrual discharge, and substitute it vicariously by its periodic occurrence. b. It may simply exaggerate the menstrual flow (menorrhagia). c. It may itself cause a hæmor-rhage from the uterus (metrorrhagia).

4. During pregnancy, purpura has a tendency to cause abortion or premature labor.

5. Prognosis should in all cases be guarded, but in a general way it may be said that purpura is more serious in the woman than in man, and in pregnancy than when the uterus is empty.

6. Metrorrhagias have a graver prognosis than menorrhagias.-Annale de Gynécologie, October, 1881.

A CASE OF MANIA AFTER SCARLATINA.-Cases of psychical disturbance as a consequence of scarlatina are extremely rare, two cases, as far as we know, being all that have been as yet reported. The case reported by Dr. J. ROBUSKE, in which a cure was ultimately affected, is therefore deserving of mention. The patient, a man aged twenty-one years, after a mild attack of scarlatina, in which there was delirium, was affected with hallucinations and subjective sensations; he could not be kept in bed, moving restlessly up and down his room, and tearing his clothes and bed coverings. This condition lasted about a week, when, under the action of chloral and morphia, he gradually improved; was willing to remain in bed and take nourishment. A decided desquamation of cuticle occurred at about this time, accompanied by violent neuralgia of the lower extremities; after about two weeks illness in all, he recovered completely.—Deutsche Med. Woch., Oct. 8, 1881.

CALABAR BEAN IN TETANUS.—Mr. J. THOMPSON HAYNE reports three cases of traumatic tetanus treated with hypodermic injections of one-sixth of a grain of extract of physostigma; of his cases two recovered and one died.—British Med. Journ., Oct. 29, 1881.

A NEW SYMPTOM OF DISTURBANCE OF THE BILIARY FUNCTION. From a long and valuable article on this subject, MM. LEPINE and GUÉRIN draw the following conclusions: 1. It is possible in an animal, either by establishing a biliary fistula in the peritoneal cavity, or by keeping the biliary passages for several hours under pressure, to produce the passage into the urine of an extraordinary quantity of incompletely oxidized sulphur, additional proof of its biliary origin being found in the slightly oxidizable properties of taurine and its derivatives.

2. In man, above all, when the excretion of bile is obstructed, the same anomaly may be found in the urine, though in a less degree. In general, it is transient, so that in a few days the opposite extreme may occur, or the normal condition be regained. In every case, the essential characteristic of this condition is not the increase alone of incompletely oxidized sulphur, but the increase in the proportion of difficultly oxidizable sulphur.-Revue de Medicine, Nov. 10, 1881.

COLLYRIUM FOR DISSOLVING METALLIC FOREIGN BODIES FROM THE CORNEA.-Dr. RODRIGUEZ reports the following case (Revista de Sciencias Medicas, 25 Oct., 1881).—A blacksmith, aged eighteen years, while forging a piece of iron, received in his left eye a small splinter of the metal, which remained there incrusted, in spite of all attempts to remove it. The following wash was then employed: Rose water, 90 grm.; Iodine, .05 grm.; Iodide of Potass., .05 grm; the result was extremely satisfactory. The particle of metal was transformed into a scluble iodide of iron, and all traces of the foreign body had disappeared. The cornea regained its normal condition, and vision remained unaffected. -Journ. de Méd. de Paris, Nov. 12, 1881.

THE TREATMENT OF SOFT CHANCRES AND CHANCrous Buboes by Salicylic ACID.-Without being an infallible specific which will take the place of all the other agents employed in these cases, salicylic acid is capable of rendering the most important service. It

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has the merit that it is without odor, gives but little pain, is soluble in alcohol and glycerin, and does not soil the linen. As a vehicle, glycerin presents many advantages: it does not evaporate, and it maintains on the surface of the ulcers a permanent coating which prevents the access of air. The following formula is employed by Dr. Autier: Acid Salicylic, 2 grammes. Glycerin, 100 grammes.—Thésé de Paris-Dr. Autier, Journal de Thérapeutique, October 25, 1881.

SUCCESSFUL PORRO OPERATION.-The seventh Porro operation at the Santa Caterina Hospital of Milan, and the fifth success in order, was performed by Dr. Paolo Negri, Second Assistant of the Royal School of Obstetrics. The case was one of malacosteon, with a badly deformed pelvis; and the operation was performed on October 9th inst. Two weeks later the woman was regarded as safe for recovery. This gives Italy 34 Porro operations and 13 recoveries. The 7 cases in Santa Caterina Hospital resulted as follows: Deformed by 1. Rickets.

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A NEW SOLVENT FOR DIPHTHERITIC MEMBRANE.— Dr. W. HALE WHITE recommends spraying the throat, in cases of diphtheria or the trachea after tracheotomy, with an acid glycerin of pepsin, warmed up to 110° F. The fragments of membrane coughed up in the case in which it was used, he reports, were very soft and gelatinous as compared with ordinary diphtheritic membranes. He thinks, however, that the chief value of the pepsin is not to digest the large pieces of membrane, but to mix with the secretion in the smaller bronchi and prevent the formation of membrane there. The child died some time after, how long is not stated, from broncho-pneumonia; and it is reported that there was no evidence to show that the pepsin had had any evil effect on the air-tubes.-Lancet, October 22, 1881.

POISONING WITH CHLORATE OF POTASSIUM.-From a number of experiments made by Messrs. Brouardel and SHOTE they conclude that: First. Numerous examples leave no doubt as to the fact that large doses of chlorate of potassium (35-40 grammes for an adult, eight or ten times less for a child of two or three years) can produce death. Second. The intervals during which the successive doses are administered exert a great influence on the development and gravity of the toxic effects. If the doses are separated by long intervals, rapidity of elimination diminishes the danger. When they rapidly succeed one another, the danger is much greater.Jour. de Med. de Paris, October 1, 1881.

TREATMENT OF SPERMATORRHOEA. - Dr. NowATSCHEK reports in Schmidt's Jahrbücker, January, 1881, a case of spermatorrhoea consequent on typhoid fever, the diagnosis resting on the presence of spermatozoa in the fluid which was constantly oozing from the urethra. Iron, quinia, and cold applications to the genitals were tried in succession with some success, but a cure was not accomplished. Lupulin, camphor, and bromide of potassium were without effect. ́ Atropia was then employed, and the patient was completely cured in five days. The author cites a second case where he was equally successful with the hypodermic injection in the perineum of a one-per-cent. solution of atropia.—Jour. de Med. de Paris, October 8, 1881.

apart, the pelvis fixed. The limit of the flexion is the vertical position of the elevated arm. Mild inspiration during the flexion; at its termination expiration. Execute these movements from six to eight times.

These exercises, if faithfully carried out, improve the shape and capacity of the thorax and check the development of incipient phthisis. According to Dr. Dally, dyspnoea, polysarca, and arthritic conditions are removed or sensibly ameliorated. Venous stases, varicose dilatations, and infarctions are, after some weeks of such movements, much improved when the circumstances are favorable. The great obstacles to this hygienic medication in our civilization are, the habitual idleness and laziness, and the indisposition to devote time and interest to such means, is the conclusion of Dr. Dally.-Bull. Gen. de Thérap., Sept. 30, 1881.

INJECTIONS OF BROMIDE OF POTASSIUM IN GONORRHEA.-In eighteen patients under observation there was noted in fifteen a rapid diminution or complete suppression of the erections. The injections are not very painful. They are used five times a day, the last injection being practised just before retiring. They

should be retained in the canal one or two minutes.

The following is the formula: Water, 150 grammes. Glycerin, 10 grammes. Bromide of Potassium, 6 grammes. Laudanum, 2 grammes.—Journal de Thérapeu tique, October, 1881.

CASE OF GALVANO-PUNCTURE IN AORTIC ANEURISM. -Mr. RICHARD CANNON reports the case of an aortic aneurism which had almost reached the point of rupture, the skin being reddened and very thin over the connected with twelve Stöhrer cells. It is stated that tumor, which was cured by the insertion of two needles when the needles were withdrawn no current was to be detected, so the favorable results may with equal probability be attributed to the mere presence of the needles or to the electrolytic action. The needles remained in the tumor only twenty minutes; at the end of ten days the tumor, which had only been the size of a walnut, had flattened down to the chest walls, pulsation and redIodide of potassium was administered internally throughness had disappeared, and there was no pain or cough.

out the treatment-Lancet, October 22, 1881.

GENITAL REFLEX.-Dr. E. W. Saunders reports, in the Alienist and Neurologist for October, 1881, four cases of paroxysms of abdominal pain associated with adherent prepuce. In each case a cure followed cir

cumcision.

SENILE OSTEOMALACIA. From a long paper on this subject Dr. EMILE DEMARGE draws the following conclusions:

ARSENIC INTERNALLY AND SUBCUTANEOUSLY IN THE TREATMENT OF LYMPHOMA.-A woman of sixty-five had difficulty in swallowing, and breathing and suffered from general feebleness, deafness, etc. Her condition was cachectic. Examination revealed a tumor in the posterior pharynx filling up the nasal and pharyngeal cavities; the submaxillary and axillary glands were also swollen and hard. These growths were made to disappear, and the woman was regarded as cured in five months. This remarkable result was accomplished by the combined internal and parenchymatous administration of Fowler's solution. The arsenic was given in large doses, mixed with acetated tincture of iron, from 8 up to 25 drops three times a day. In this way 28 grammes were consumed in the course of the treatment. The injections consisted of equal parts of Fowler's solution and distilled water, of which there was injected from one to three-tenths of the capacity of a Pravaz syringe (about 3 to 9 minims). There was but little reaction of the general organism, but a marked acceleration of the pulse. Locally, the tumors increased considerably in size with the first injections, but after the second week rapidly declined.-Berl. Klin. Wochen. 1880, No. 52.

CZERNY has employed the method of Billroth, above described, in the cure of glandular lymphomata. In six months he obtained a complete cure of a case, in which the patient had taken 746 drops and had received 76 injections of 10 drops each.-Wien med. Wochen. 1881, No. 2.

TREATMENT OF SUBACUTE AND CHRONIC ARTICULAR AFFECTIONS BY OAKUM.-Dr. CONSTANTIN PAUL has employed with success, at Lariboisière, the substance called oakum. The affected articulation is completely enveloped to a thickness of 1 or 2 centimetres. Treated thus, a case of arthritis deformans has been much relieved in some weeks. It has produced the best effects in bronchitis, in place of Burgundy Pitch plaster.-Bulletin Gen. de Thérapeutique, Sept. 15, 1881.

THE METHODICAL EXERCISE OF RESPIRATION IN RELATION TO THE CONFORMATION OF THE CHEST AND

TO THE GENERAL HEALTH, is the title of a paper by Dr. DALLY, in which, after discussing various physiological questions concerning the respiratory organs, he proposes certain methodical movements for exercising the thorax.

1. The first or normal, is the vertical position, perfectly erect, as if standing against a wall, the arms hanging by the side. This position should be taken and kept for ten minutes at a time, a number of times a day.

2. The two arms and the hands are extended horizontally forwards, the palms of the hands facing. The hands are separated slowly, whilst the chest is inclined forward. Remain in this position thirty seconds, and inspire deeply by the nose. Return to the initial position, and expire. Execute this movement six times.

3. The arms hang by the body; raise them upwards -the fingers well extended-above the head, the palms looking forward. Take a deep inspiration. Let fall the arms alongside the body, palms open, and expire slowly.

4. Double rotation at the side. The subject being in the normal position (first), executes as large as possible, the arms well extended, double rotation laterally, and inclining the trunk forward each time that the arms are thrown behind, and never projecting the belly forward. This movement is executed entirely by the scapulo-humeral articulation.

5. The arms are crossed horizontally, the palms of the hands looking backward. Flexion lateral, alternately, of the trunk. The flexion will be then regular, transverse, the abdomen drawn in, the legs extended

1. Osteomalacia can develop in old people as in adults.

2. We can admit clinically the existence of a form of osteomalacia localized in the vertebral column, the thorax, and the pelvis, and, although this form is more frequent in the aged, it can also develop in adults.

3. So-called senile osteomalacia is completely distinct from senile osteoporosis, and has the same lesions as true osteomalacia occurring in adults, from which it differs simply in the age of the subject in which it develops.-Revue de Medicine, September 10, 1881.

HÆMOSTATIC PILLS.-Dr. Huchan prescribes the following formula for hemorrhages of different kinds, as metrorrhagia, epistaxis, hæmoptysis, etc.

R Ergotin, Quiniæ Sulph. ãà 3ss Digitalis, Ext. Hyoscyami aa gr. v. M. ft. pil. no. x. One every 2, 3 or 4 hours.-Journal de Thérapeutique, 10 November, 1881.

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