five or six are proper subjects. He recommends primary division of the tendo-Achillis, then, of the posterior tibial tendon, and if this will not bring the foot into good position, open incision of the plantar structures will give a successful result.

THE TREATMENT OF HAIR-MARKS BY ELECTROLYSIS

was advocated by Dr. GEO. H. Fox, of New York, it having been suggested by the successful application of the method for the removal of superfluous hairs. The treatment of superficial nævi by this means was contrasted with scarification, as recommended by Balmanno Squire, of London, and preference given to the electrolysis. The objections are tediousness of operation and severe pain; it is not applicable, on this account, to young children. Some slight scarring must be expected.

Dr. SHERWELL, of Brooklyn, preferred multiple puncture, with needles dipped in caustics, to the electrolysis, Dr. H. KNAPP, of New York, had obtained good results from extirpation, either by dissection or caustic, and he finds that subsequently the remainder will obliterate. If possible, we should discern the startingpoint of the telangiectasis and remove it.

Dr. SHERMAN, of Ogdensburg, reported a case cured by the procedure recommended by Dr. Knapp.

Dr. A. VANDERVEER reported an attempted

SUBCUTANEOUS SECTION OF THE NECK OF THE FEMUR, in a case of ankylosis of the hip, and explained the method of performing the operation. The lady had suffered with prolonged hip-disease, and being given up as hopeless by her physicians, the limb was allowed to assume a very awkward position, in which ankylosis finally occurred. A subcutaneous operation was attempted, but the saw breaking in the wound, it was found necessary to enlarge the incision and remove the saw with the forceps, virtually making an open wound. After section of the neck of the femur and extension, it was found that tenotomy of the adductors was needed. The limb was now placed in a good position. An abscess occurred at the site of the wound, but the patient finally recovered, and a false joint was obtained. The limb is now straight and useful, with good motion at the hip.

THE DIVISION OF OPTIC AND CILIARY NERVES FOR
SYMPATHETIC OPHTHALMIA

was advocated, by Dr. H. D. NOYES, of New York. Two forms of sympathetic ophthalmia are observed: (I) the irritative, (2) the inflammatory. The former sometimes merges into the latter, but the inflammatory form may arise without being preceded by inflammation. Sympathetic ophthalmia of the irritative form, and the milder cases of the inflammatory form, are generally checked by enucleation of the offending eye; in some other cases of inflammation this, for some unexplained reason, is not sufficient. The modification of the original operation of cutting the nerve is performed by going between the internal rectus and the superior or the inferior, into the depth of the orbit, dividing the optic nerve, and everting the globe, in order to completely divide all the nerve-fibres, Some operators divide one or both of the lateral recti-muscles. Simple neurotomy sometimes is followed by reunion of the nerves, the sensibility of the cornea returning in about twelve months; neurectomy, removing a small piece of the optic nerve, is, therefore, to be preferred to simple division of the nerve, with a view to the ultimate success of the operation.

Optico-ciliary neurectomy is to be preferred as a prophylactic in cases where the affected eye is (1) extremely tender on pressure, and (2) subject to repeated attacks of inflammation. Under these circumstances, it will affect the other eye sooner or later. It may also be

performed in other cases where enucleation should be performed, but where consent to extirpation of an offending eye cannot be obtained.

In cases of absolute and painful glaucoma this operation has the advantage of reducing the tension of the globe and retaining its normal appearance and size. Dr. KNAPP approved of all that had been said in regard to the importance of preventing sympathetic ophthalmia, but could not endorse his remark that optico-ciliary neurotomy is in general favor among specialists. He had performed it himself nine times, in one of which gangrene of the globe occurred. Von Gräfe had written a monograph upon the subject and pointed out many cases in which this operation is entirely inadmissible. At the Ophthalmological Section of the International Medical Congress the subject was freely discussed and many bad results and some fatal cases reported. In many cases the operation only serves to delay enucleation until it is too late to be of service.

Dr. Roosa opposed the operation, and would never perform it.

Dr. L. D. HALLOWELL, of Buffalo, advocated division of the ciliary nerves in proper cases as a preliminary eign bodies in the eye. measure, though not intended to be applicable to for

MEMOIR OF THE LATE DR. JAMES P. WHITE, of Buffalo, by Dr. AUSTIN FLINT, was presented and referred to the Committee of Publication.

Dr. L. D. BULKLEY, of New York, read a paper entitled,

THE MALIGNITY OF SYPHILIS,

views recently enunciated that syphilis may be rewith an analysis of 450 cases, protesting against the garded as a benign disease. Dwelling upon the prevalence of the disease and its varied manifestations, he concluded that it is, in point of frequency, only second to phthisis. It is closely related to scrofula and similar degenerative disorders.

His consideration of the subject was`summed up as follows:

1. Syphilis is a constitutional infectious disease of which the first outward manifestation is the chancre, initial lesion, or initial sclerosis at the site of entrance of the virus.

2. While this primary lesion commonly presents points by which it may be recognized, in other instances it is very difficult to speak with positiveness from the local lesion alone, and, therefore, cases presenting only local signs must, as a rule, be excluded from any consideration of syphilis as regards the pathological tendencies of the disease.

3. In a certain proportion of cases constitutional syphilis is a mild affection, even as other infectious diseases occur, with varying severity under different conditions.

4. The causes of the differences observed in certain cases of syphilis are as yet unknown. Individual constitution, surrounding circumstances, the discharge of the virus received, proper treatment, and possibly partial protection through hereditary influence of the disease, are elements of importance in every case.

5. No definite prognosis can be made from the character of the initial lesion of syphilis, as to the progress of the disease if left untreated. Cases which at the beginning seemed insignificant, have in later years proved most serious, while, in many instances of late lesions of syphilis, no satisfactory history at all can be obtained in regard to the initial sore, it having been so slight, or so concealed, as to have escaped notice.

6. In view of the very severe and extensive manner in which syphilis may at some time during its course affect any or all of the tissues of the body, and the destructive pathological tendencies of the disease under

A Few Original Thoughts on Cholera, by H. RAYMOND ROGERS, M.D., of Dunkirk.

And Facial Paralysis occurring in Connection with Aural Disease, by S. SEXTON, M.D., of New York.

Dr. D. H. GOODWILLIE, of New York, read a paper on Application by Insufflation of Medicated Powders to the Upper Air-Passages, for the Relief of Catarrhal Conditions, which was referred to the Publication Committee.

Dr. E. H. M. SELL, of New York, read a paper

ON THE USE OF AVENA SATIVA,

in which he recommended the use of concentrated tincture of avena sativa or maltine, as a nerve stimulant and general tonic in the neuroses. The concentrated tincture is invaluable as an antidote to the opium habit, and he reported several striking cases which were cured by it.

Dr. SQUIBB offered a resolution that writers of papers for the future sessions of the Society, either limit their papers to twenty minutes, or prepare an abstract for reading, and that any motion to extend the prescribed time shall not be in order. Adopted.

THE MEDICAL SOCIETY OF THE COUNTY OF NEW

YORK offered a communication pointing out defects in the medical law of 1880, and asking that appropriate amendments, or a new bill be recommended to the Legislature, so as to define clearly what is meant by a practitioner of medicine, and second, to prescribe a penalty for perjury in registration; as the present law is inoperative against magnetic physicians. These points were embraced in resolutions, which were adopted.

Drafts of bills from the Committee on Legislation were approved and recommitted.

THE REPORT OF THE COMMITTEE ON NOMINATIONS, as follows, was presented and adopted:

President.-Harvey Jewett, M.D., of Canandaigua. Vice-President.-E. D. Ferguson, M.D., of Troy. Secretary.-Wm. Manlius Smith, M.D., of Syracuse. Treasurer.-Charles H. Porter, M.D., of Albany. Chairman of Committee of Arrangements.-S. B. Ward, M.D., of Albany.

Honorary Members. Drs. Roberts Bartholow, of Philadelphia; Sidney Ringer, of London; Charles M. Ewing, of New York.

Eligible for Honorary Membership. - Drs. Theodore G. Wormley and William Goodell, of Philadelphia.

After a short farewell address by the President and the usual vote of thanks, the Society adjourned to meet at Albany, on the first Tuesday in February, 1883.

CORRESPONDENCE.

MEMPHIS ITS SEWERS AND ITS HEALTH. To the Editor of the MEDICAL NEWS:

A statement has been going the rounds of the newspapers, that the mortality of Memphis has increased since the introduction of the Waring System of Sewerage. This statement would seem to imply that the sewers have, to say the least, been a factor in the increased death-rate.

It may be said that a problem is being worked out here, in which our community especially, and sanitarians generally, are deeply concerned, and as this question is one of public interest, I propose to state, briefly, the facts as far as I am acquainted with them.

This system of sewerage was inaugurated by the laying of pipe, January 20, 1880. House connections were begun March 1, 1880. On July 1, of the same year, twenty miles of sewer had been laid. The system was practically completed, July 1, 1881, when thirtyfour miles of sewer-pipe had been laid, and 3579 waterclosets had been connected with it.

It will appear from these data, that during the year 1880, the sewers were in operation to a limited extent, and only during the latter part of the year; while they were in full operation during most of the year 1881.

It is proposed to compare the mortality for 1881 with that of 1880. No allusion is made to 1879 and 1878, because they were epidemic years.

The total mortality for 1880 was 1054; for 1881 it was 1276. This increase of mortality was distributed quite evenly through the year. During the last quarter of 1881 the mortality was a little less than for 1880, being 272 against 279 for the same quarter of the year previous.

The increased mortality for 1881 was observed in both the white and the colored races, except for the last quarter of 1881, when the death-rate among the whites was less, and among the blacks was greater than for the corresponding quarter of 1880.

The deaths from zymotic diseases generally were 274 for 1880, and 320 for 1881.

The mortality from all the forms of malarial fevers, including typho-malarial, was nearly the same for each year, being 101 for 1880, and 99 for 1881.

The number of deaths from typhoid fever was 17 for each year. Dysentery destroyed 70 lives in 1881; only 45 in 1880. Diphtheria, 43 in 1881; only 12 in 1880. Consumption carried off 168 in 1881, and 157 in 1880. Acute diseases of the respiratory organs destroyed 102 in 1880, and 124 in 1881.

It is generally conceded that the operation of the sewers has been eminently satisfactory. There is no ground for the complaint of sewer-gas in dwellings, and the pipes are believed to be comparatively free from it.

To July 1, 1881, it had been found necessary to cleanse a portion of the mains, of deposits, only twice; and the laterals not at all. To the same date, only twenty-one cases of obstruction by sticks, rags, etc., had occurred in the six-inch pipes, and these had been removed at an average cost of $15 each.

The only defect in the works yet discovered, has arisen from an error of calculation. It is, that the two fifteen-inch mains, running parallel to the bayou, are too small to carry off readily the sewage from the laterals. As a temporary means of relief to these mains, there have been established at five points overflows into the bayou.

I cannot see how the system of sewers can in any way be held responsible for the increased mortality of 1881. By this system we have been relieved of the great evil of soil-pollution; but it would seem that something else than sewers is necessary to make the health of this city what it should be. What this is remains to be discovered.

It must be remembered that one feature of the Waring system is soil-drainage. This it accomplishes but to a very limited extent, because here the network of pipes encloses no areas less than three hundred feet square, and in many portions of the city, much larger areas are dependent upon these pipes for drainage. Furthermore, the drain-pipes, which lie alongside the sewerpipes, are, in very many places, twelve feet and more below the surface; and, as the soil contains much clay and is very retentive of moisture, these drains exert no influence in the way of drying the surface soil.

My belief is, though I have been able to obtain no mathematical data, that the general level of the subsoil water has not been materially lowered by the sewer system here; and, in the light of past observations upon this point, in other localities, we may not reasonably look for much reduction in our death-rate until our drainage is radically improved.

The water-supply of this city is objectionable upon two grounds:

1. It requires filtering to make it suitable for cooking,

washing, or drinking, and this is impracticable for the largest portion of the population.

2. The source from which the water is obtained is open to contamination, through the influence of backwater at certain times, from the drainage of slaughterhouses, stockyards, and sewers.

The investigations of Major Benyard (United States Engineer Corps), made for several months past, and still being carried on, show that when the Mississippi is high, and Wolf River low, a current sets in below the mouth of the present outlet of the city sewers, and carries the water from this locality, as well as that which is polluted by the outflow from Bloody Bayou and Bayou Gayoso, above the point at which the city supply is taken.

The influence of such water as this upon the public health, must, of necessity, be prejudicial. The water company who have recently come into possession of the works, seem determined to remove all objectionable features, and I have no doubt will ultimately give the city good water.

Memphis has an honest and intelligent government, and an energetic and faithful Health Board, who are doing everything in their power to make the city what it ought to be, from a sanitary as well as a commercial standpoint. But Rome was not built in a day! To Dr. G. B. Thornton, President of the Board of Health, I am indebted for free access to all the records of his office, and for much information pertaining to this subject. Yours, respectfully,

R. B. MAURY, M.D.

NEWS ITEMS.

ALBANY.

(From our Special Correspondent.)

MEETING OF NEW YORK STATE MEDICAL SOCIETY. -In spite of the snow blockade that has interrupted travel to some extent throughout the State, the annual meeting of the Medical Society of the State of New York was held at Albany, convening on Tuesday, the 7th inst., according to appointment, and a large and unusually active meeting was held. New York City was well represented by the President of the Society, Dr. Abraham Jacobi, and by Drs. Vanderpoel, Agnew, Elsberg, Bulkley, Piffard, Roosa, Squibb, Seguin, Gibney, Bull, Sturgis, Rockwell, and others, while from the State perhaps a larger number were present than at any previous meeting. Drs. Moore and Ely, of Rochester; Potter and Roe, of Elmira; W. Manlius Smith, Felton, and many other prominent members of the profession in the State were also noticed to take an active part in the proceedings.

The interest of the session, apart from the scientific work, centred especially around two proposed measures, involving the general and political interests of the practitioner. The first was a new code of ethics; the second, new legislation regulating the right to practise. The first had been referred to a committee at the last meeting, whose report was now presented, and by direction of the Business Committee and the vote of the Society it was made the special order for discussion upon Tuesday evening. The question was one which deeply interested the members, inasmuch as it warranted consultations with irregulars. While the New York City delegation were almost entirely in favor of such a radical change, the State members were opposed to it. A motion offered by Dr. Roosa, of New York, as a substitute for the report, nearly succeeded in passing, although in effect it entirely threw overboard all codes of ethics, and left the subject to each individual prac

children must produce certificates of vaccination before they can be admitted.

The National Board of Health have recently issued a circular letter to the heads of Government departments, recommending "that prompt measures be taken for securing, as far as may be practicable, the vaccination or revaccination of all the employés of the Government," and the Secretaries of the Treasury and Interior, and the Postmaster-General have already called the attention of their employés to the necessity of complying with this recommendation.

It is quite a relief to the people of the District of Columbia to feel that they have something to boast of in exemption from small-pox, after the serious misrepresentations that have gone abroad on the subject of "Washington malaria."

SMALL-POX.-The mortality returns for the week ending February 4, give the following number of deaths from small-pox: New York, 20; Philadelphia, 12; Boston, 1; Allegheny, 17; Erie, 1; Montclair, N. J., 1; Richmond, 12; Norfolk, 1; Dayton, 10; East Liverpool, O., 1; Indianapolis, 1; Louisville, 1; Chattanooga, I; Milwaukee, 4.

For the week ending January 28, there were 9. deaths in Hudson County, N. J., I in San Francisco, 4 in New Orleans, and 1 in Holyoke, Mass.

On the 6th inst. there were 14 new cases and 6 deaths,. and on the 7th, 6 cases and 2 deaths, from the disease in Chicago; and during last week 18 new cases in Richmond.

HEALTH IN MICHIGAN.-For the week ending January 28, 1882, the reports indicate that bronchitis and influenza have increased, and that tonsilitis, membranous croup, typho-malarial fever, remittent fever, and diphtheria have considerable decreased, in area of prevalence.

Cases of small-pox are reported as follows: in Crystal Lake township, Benzie Co., January 7; in Prairie Ronde, Kalamazoo Co., January 24; in Port Huron township, January 24; in Watson township, Allegan Co. (I case), January 26; in Pontiac township (4 cases derived from a tramp), January 28; at the villages of Menominee (2 cases), Waucodah (3 cases), and Spalding (3 cases), in Menominee Co., January 28; at Bay City (convalescents), January 28; at Escanaba, Delta Co., January 28; at Detroit, January 28; at Grand Rapids (convalescents), January 31; and in Park township (brought from Leesburg), St. Joseph Co., February 2, 1882.

LEPROSY IN MINNEAPOLIS.-We are informed that a leper, aged twenty-six, died at Minneapolis, on February 1. The disease first manifested itself upon his arrival in this country, six years ago, and during this time he has endured great suffering.

VACCINATION OF EMPLOYÉS, ETC. -The Louisville and Nashville and Short Line Railroad Companies have followed the example of the Pennsylvania Company, in requiring a certificate of vaccination from its employés. The contagion of this exemplary act we hope may outrun the small-pox.

In a letter to the Postmaster-General, the President of the National Board of Health strongly recommends the vaccination or revaccination of all persons employed in the Government departments.

An ordinance has been published by the City Councils of Richmond, Va., compelling the vaccination of all persons who have not been vaccinated within twelve months, except in cases where any regularly licensed physician shall declare it to be injurious or

unnecessary. Any person refusing to be vaccinated, or to allow his or her child, children, or wards to be vaccinated within fifteen days after the passage of this ordinance, is liable to a fine of five dollars.

OBLIGATORY VACCINATION IN SWITZERLAND.-During the passage of a new law on epidemics, the Swiss National Council (Gaz. Hebd., January 1), adopted by ninety votes against twenty-three the principle of obligatory vaccination. Every infant born in Switzerland must, according to this law, be vaccinated during the first year of its life, or at latest during its second year; and infants born out of Switzerland, if not previously vaccinated, must submit to the same rule. No child can be permitted to frequent a public or private school without a certificate of vaccination.-Med. Times and Gaz., Jan. 14, 1882.

DISINFECTION OF CLINICAL THERMOMETERS.—In a letter to the Lancet, January 14, 1882, Dr. HASSALL draws attention to the importance of thoroughly disinfecting clinical thermometers after use, by washing them in a solution of permanganate of potash or carbolic acid, so as to avoid any danger of transferring contagious diseases from one patient to another.

ADULTERATION OF FOOD AND DRUGS BILL.-A bill has just been presented in Congress to prevent the adulteration of food and drugs. According to its provisions an article is adulterated:

a. In the case of drugs:

First. If, when sold under or by a name recognized in the United States Pharmacopoeia, it differs from the standard of strength, quality, or purity laid down therein.

Second. If, when sold under or by a name not recognized in the United States Pharmacopoeia, but which is found in some other pharmacopoeia, or other standard work on materia medica, it differs materially from the standard of strength, quality, or purity laid down in such work.

Third. If its strength or purity fall below the professed standard under which it is sold.

b. In the case of food or drink:

First. If any substance or substances has or have been mixed with it so as to reduce or lower or injuriously affect its quality or strength.

Second. If any inferior or cheaper substance or substances have been substituted wholly or in part for the article.

Third. If any valuable constituent of the article has been wholly or in part abstracted.

Fourth. If it be an imitation of, or be sold under the name of another article.

Fifth. If it consist wholly or in part of a diseased, or decomposed, or putrid, or rotten animal or vegetable substance, whether manufactured or not, or, in the case of milk, if it is the produce of a diseased animal. Sixth. If it be colored or coated, or polished or powdered, whereby damage is concealed, or it is made to appear better than it really is, or of greater value.

Seventh. If it contain any added poisonous ingredient, or any ingredient which may render such article injurious to the health of a person consuming it: Provided, That the National Board of Health may, with the approval of the Secretary of the Treasury, from time to time declare certain articles or preparations to be exempt from the provisions of this act; and provided further, That the provisions of this act shall not apply to mixtures or compounds recognized as ordinary articles of food, provided that the same are not injurious to health, and that the articles are distinctly labelled as a mixture, stating the components of the mixture.

Section 5 further provides, "That, in order to carry

into effect the provisions of this act, the Secretary of the Treasury is hereby authorized to appoint, from names submitted to him for that purpose by the National Board of Health, one or more suitably qualified persons as special inspectors, and as public analysts for adulterated food and drugs at such ports of entry as the Secretary of the Treasury may deem expedient; and it shall be the duty of the National Board of Health to prepare instructions governing the work of such inspectors and analysts, which, when approved by the Secretary of the Treasury, shall govern their action, and that of collectors of customs, in preventing im portation from foreign countries of food or drugs adulterated within the meaning of this act."

THE RED CROSS SOCIETY.-The International Committee of the Red Cross Society of Geneva has decided to offer for public competition three prizes of 2000 francs each, with second prizes to the amount of 500 francs. The subjects of the three essays are: 1. On Improvising the means of Treatment of Wounded and Sick. 2. On Improvising the means of Transport. 3. On Improvising an Ambulance or Field Hospital. The object sought is to obtain by the union of the three a complete work on the art of improvising the means of assistance for wounded and sick. The committee is desirous of grouping methodically all available information as to the measures by which the three important branches of treatment, transport, and ambulance may be best extemporized in cases where special provision has not been made beforehand for them. Details are given of the various matters grouped under these three headings in the circular issued by the committee, to which we must refer those interested in the subject. The essays may be in French, German, or English. They must reach the President of the International Committee, Rue de l'Athénée, 8, Geneva, Switzerland, before April 1, 1883; each essay must bear a motto, and be accompanied by a sealed note containing the name of the author. The committee reserve the right of withholding any of the prizes, should the essays appear to the jury appointed to examine them not to possess sufficient merit. The jury will be composed of members of different nationalities. If prizes are awarded, the essays are to be the property of the Society, under the condition of being published by it within a year from the date of the award of the jury.— Lancet, Dec. 31, 1881.

HOW TO AID INJURED PERSONS.-Gen. McClellan has accepted the chairmanship' of the committee recently formed in New York, whose purpose is to teach persons of all classes how to give first aid to the sick and injured, pending the arrival of a physician or surgeon, and to give instruction in nursing and in the laws of health. A large number of physicians have already volunteered their services in giving the needed instruction, and eighteen classes have been formed. Similar work has been in successful operation in London for nearly five years, under the auspices of the Society of St. John, of Jerusalem. The importance of this, the newest phase of New York's philanthropy, in supplying such instruction to the police, firemen, railway employés, workmen in factories, and, in fact, to all classes, must be generally appreciated and approved by the public and medical profession. We trust to hear soon of other cities following New York's example.

REMOVAL OF THE ENTIRE UTERUS.-On January 3, Sir WILLIAM MACCORMAC removed the entire uterus, on account of epithelial cancer of the cervix, in a woman, aged thirty-four, who had been admitted into St. Thomas's Hospital, under Dr. Ord's care, with serious intestinal obstruction. An incision was first made